| Banner School Based Clinic | |
|
855 W 8th Ave Mesa AZ 85210-3401 | |
| (480) 472-1112 | |
| Not Available |
| Full Name | Banner School Based Clinic |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 855 W 8th Ave, Mesa, Arizona |
| Authorized Official Name and Position | Dennis Dahlen (SR VP FINANCE) |
| Authorized Official Contact | 6027474000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Banner School Based Clinic 1441 N 12th St Phoenix AZ 85006-2837 Ph: () - | Banner School Based Clinic 855 W 8th Ave Mesa AZ 85210-3401 Ph: (480) 472-1112 |
| NPI Number | 1033594247 |
|---|---|
| Provider Enumeration Date | 07/29/2015 |
| Last Update Date | 07/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033594247 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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